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The intention of this research is to conduct an investigation into the medical risks in adolescent pregnancies in Sub-Saharan Africa. Available literature shows that Sub-Saharan Africa experiences higher rates of medical complications and maternal deaths, resulting from adolescent pregnancies (Farber, 2009). Various studies that explore this challenge are united on the fact that cultural factors, poor access to prenatal medical services and peer pressure are the leading factors that contribute to the medical challenges and prenatal deaths of adolescents (East & Felice, 1996). Available statistics show that the age of marriage is relatively lower in Sub-Saharan Africa than in other parts of the world.
This is mainly because of the fact that girls in Sub-Saharan Africa tend to be forced into marriages below the age of 18. Some of the factors that contribute to early pregnancies are that young girls come under heavy societal pressure to engage in sexual activities with relatively older men. Despite the inclusion of sex education into the schools’ curriculum, studies have found out that a significant percentage of young girls are still vulnerable to early pregnancies (East & Felice, 1996).
Lack of efficient systems to enforce community sensitization has been cited to be among the main reasons, which contribute to early pregnancies in schools. Statistics show that nearly 70,000 adolescents die of pregnancy related complications in the developing world. This study will focus on the medical risks that are associated with adolescent pregnancies every year. The study will also seek to expose the factors that are central to these risk factors with a goal of establishing the most suitable remedial actions that could be adopted. The study will also seek to expose weaknesses in the current approaches that have attempted to address the question of teenage pregnancies.
Various studies that have explored the matter of adolescent pregnancies tend to focus on the medical and psychosocial perspectives of the problem. Other studies have tended to focus on the factors that contribute to adolescent pregnancies in Sub-Saharan Africa (Neinstein, 2007). Research of particular cases in the region has indicated that pregnant adolescents do not readily access prenatal care. One of the reasons behind this challenge is that the stigma, associated with adolescent pregnancy, makes it difficult for the girls to seek or receive support from their parents or elders (Arai, 2009). These girls do not have stable incomes and have to rely on dependants to cater for their medical needs during pregnancies.
The high poverty index in Sub-Saharan region means that the dependants, on whom these girls rely, lack the means to take care of their prenatal medical needs (Cherry, 2001). Another reason that shields the girls from quality healthcare services during pregnancies is that the gender disparity in Sub-Saharan Africa makes it difficult for the girls to access medical care in their homes. Usually, girls do not access means of self-sustenance as boys do. Usually, the challenge lies in the fact that girls tend to seek support from elderly dependants, which makes them vulnerable to different systems of abuse within the domestic circles. At the age of 18 and below, most girls in Sub-Saharan Africa are still at low levels of education (Schneider, 2010). They lack the knowledge and skills to take care of themselves, when they become pregnant. As a result, many of them become vulnerable to medical complications that accompany pregnancies.
Research has shown that adolescents are more likely to suffer from premature births than mature women are. The period of pregnancy exerts some form of psychological imbalances in the adolescent, which makes them develop certain medical complications that cause premature death. Naturally, the state of mind is important in determining the capacity of the adolescent to hold the pregnancy. Comparatively, mature women are more mentally stable than adolescents, who have to fight with the stigma that comes from the family and members of the society. The adolescents tend to adopt a siege mentality. They acknowledge the fact that the immediate society does not endorse their state of pregnancy.
Studies have shown that many adolescents contemplate both suicide and abortion at some point (Males, 2010). Many others attempt unsuccessfully to procure abortion. Both practices tend to affect the health of the babies and the young mothers. A combination of these two factors often leads to abortion. The state of pregnancy involves heavy psychological and physical challenges to the adolescents (Males, 2010). Some of the young mothers have not developed sufficiently to enable them handle the challenges that come with pregnancy (Linsley, Kane & Owen, 2011). The biological strain that accompanies pregnancy often leads some of the adolescents to experience increased physical strains that could develop into adverse consequences such as premature births and miscarriages (Males, 2010).
Research has indicated that adolescent pregnancy is also associated with poor access to contraceptives (Males, 2010). The outlying areas outside the African metropolis have poor access to contraceptives because governments and donors cannot easily access these regions. Lack of contraceptives places significant challenges on sexuality and reproductive health matters for adolescents. The levels of vulnerability to teenage pregnancy are usually linked to the vulnerability to sexually transmitted diseases. The frequencies of adolescent pregnancies have also been correlated with the amount of exposure and the levels of permissiveness for the African societies in the Sub-Saharan parts of the continent.
The problematic transition of girls into the state of womanhood is also quoted to be among the key factors that influence adolescent pregnancies in Sub-Saharan Africa. Cultural factors that determine the transition of girls into women lack sufficient structures to cater the health needs of the girl child (Dean, Ducey & Malik, 1998). These deficiencies ultimately expose the young women to health challenges, when they become pregnancy before the age of 18. The major implications of the health challenges that relate to adolescent pregnancy are that they affect adversely on the state of health of the expected newborn babies. Research, conducted in Sub-Saharan Africa, has related the high incidences of infant mortality rate to the adolescent pregnancies (Dean, Ducey & Malik, 1998). Children, born of adolescent mothers, are more susceptible to health complications than those, born of mature women are.
One of the prevalent health challenges in adolescent pregnancies is low birth weight. Research literature shows that children born of adolescent mothers are more likely to exhibit the problem of low birth rate than those, born of relatively mature mothers (Dean, Ducey & Malik, 1998). The health practices and lifestyles of girls who fall pregnant during adolescence usually expose them to certain health risks that affect the development stages of the baby. In an effort to conceal the outward symptoms of pregnancy, girls will tend to adopt certain nutrition practices in order to maintain smaller shapes of their bodies. For instance, some of them will tend to avoid meals or turn to junk food in the hope of maintaining their pre-pregnancy bodies. Some of these practices have been blamed for the low birth weight of their babies.
There is often the tendency among pregnant adolescents to seek medical attention during the third trimester of their pregnancies. Various social and psychological reasons account for this. The lengthy periods that are taken before the adolescents seek prenatal medical care have been cited among factors that complicate the maternal health of expectant adolescents (Leik, 2007). Biological development of adolescents varies across individuals. Despite the fact that scientific research has proved that girls are reproductively mature by the age of 13, other findings show that this age is associated with higher levels of vulnerability in the cases of pregnancies (White & Truax, 2007). The indication that biological factors of adolescents influence their general growth is explained by the fact that more adolescents are more susceptible to fistula and other complications that relate to childbirth. Past statistics have also indicated that the maternal mortality rates are likely to be higher among adolescents than in mature women.
Numerous studies have been tasked with the responsibility of explaining the biological impacts of early pregnancies on adolescents, few studies have attempted to explore the kind of association that exists between the psychological and biological factors. Researches conducted on adolescent pregnancies in Sub-Saharan Africa have indicated that the mental development of the adolescents has a significant impact on the health status of the adolescents during pregnancies (Seidman, 2008). Sub-Saharan Africa is largely patriarchal in terms of its socio-cultural organizations. This part of the continent is regarded as a place for the systematic subjugation of the rights of women. Sociological studies have offered the explanation that the patriarchal edifice regards the women’s body as a terrain for conquest. It is because of this reason that young women below the age of 18 are brought under the influence of the domineering power of patriarchy.
Sociologically, the high incident of adolescent pregnancy in Sub-Saharan Africa is culturally perceived as the outward manifestation of triumphant patriarchy. The patriarchal edifice considers free women as agents inimical of its power. Adolescent pregnancies have been considered variously as a device for the patriarchal world order to place the resurgent feminism within controls. Notably, societies that exhibit higher levels of matriarchal influence are less likely to show high incidences of adolescent pregnancies. The manifestation of these powers hints at a latent struggle for control of cultural and social power across the gender divide. Similarly, societies that invest more in the education of the girl child are less likely to suffer from the phenomena of early pregnancies as compared to societies that block the movement of women into positions of power.
The use of sex as an instrument of patriarchal control has also been quoted as one of the factors that influence teenage pregnancy. The struggle for the domination of the patriarchal mindset has often included the desire to possess and subdue a woman’s body. It is within this context of understanding that the health challenges, facing pregnant adolescents, have been contextualized within the cultural milieu of the Sub-Saharan setting. Some studies have attempted to explore the cultural links that determine the state of reproductive health of the African girls (Seidman, 2008). This cultural link and social matters must be understood together with some of the cultural practices that include female genital mutilation. Female genital mutilation (FGM) remains a rampant practice in many communities of Sub-Saharan Africa. Generally, FGM is based on the need to control the sexuality of the African girl child in order to keep her place and profile in the society (Dean, Ducey & Malik, 1998).
Pregnant adolescents comprise a vulnerable segment to HIV and AIDS pandemic. Sub-Saharan Africa is one of the regions that are adversely affected by HIV and AIDS pandemic (Dean, Ducey & Malik, 1998). The high levels of vulnerability and prevalence have been linked to socio-cultural factors and poor access to resourceful information. Generally, the continent is challenged in terms of the budgetary allocations necessary to contain the spread of diseases. The naivety of the adolescents exposes them to the disease as they lack sufficient information on matters of sexuality. The high incident of teenage pregnancy illustrates the fact about the shortage of contraceptives and inaccessibility of knowledge and information. Up to this level, it might be argued that the health challenges, facing pregnant adolescents in Sub-Saharan Africa, result from a multiplicity of factors that range from medical, educational, cultural, and socio-economic.
In the course of time, various steps have been taken into place with the objective of arresting the high incidence of adolescent pregnancies. Generally, two approaches have been used in an effort to increase the knowledge levels of adolescents and shield them from the adverse effects of early pregnancies. The first approach has been the development of a knowledge–based system of managing the prenatal needs of the underage mothers. These needs are divided into the health needs and the psychosocial needs. The pregnant adolescents are regarded as a vulnerable section of the society who cannot manage their situation in a manner that allows them to integrate sufficiently with the larger society.
The prenatal care offered to the adolescent mothers is aimed at assisting them carry on with the pregnancies in ways that are not injurious to their reproductive health. The programs are designed to take care of the health needs of the pregnant adolescents and the unborn babies. This part of the program is meant to fill into the gaps, created by the socio-economic deficiencies and social stigma, which prevent the pregnant adolescents from seeking or accessing prenatal care. The need to balance the emotional, psychological, and physical needs of the adolescents forms the integral part of this intervention strategies. Past studies have also argued for the need for the adolescents to be equipped in terms of the basic knowledge about childcare to prepare them for the task of motherhood.
Research on adolescent pregnancies has shown that the young mothers are faced with daunting psychological challenges during the early parts of motherhood. According to these studies, the pregnant adolescents find themselves in an intricate situation, concerning self-identity. On the one hand, the adolescents have lost their identity as children. The pregnancy and the coming of the baby mean that they have transcended into the process of motherhood. On the other hand, the adolescents have not matured psychologically into the role of motherhood. This lack of a clearly identified role imparts on them challenges that require tender psychological counseling.
Another remedial approach that has been directed towards pregnant mothers involves preventive care. This involves the systematic sensitization of the young girls about the possible dangers of unprotected sex. This kind of response should take place both in formal and informal levels. Informally, the vulnerable groups are to be introduced into a comprehensive body of knowledge that prepares them for the possible impacts of adolescent pregnancies. This information section is created out of the awareness that those school curriculums are not sufficiently structured to cover the expansive field of reproductive health. Past studies that have explored the apparent mismatch between curriculum designs and reproductive health have cited time limit as one of the challenges that cause inefficiency in the dissemination of the information.
One of the strengths of this study is that it attempted to situate the problem of teenage pregnancy within a multiplicity of perspectives. Particularly, the inclusion of the cultural perspective into the study was resourceful in the sense that it would provide deeper insights for the health care workers into the problem of adolescence pregnancy. The occurrence of adolescence pregnancy is understood as a social problem with diverse connections and linkages with different forces. Another important strength of this research is that it incorporates combined strategies that aim at preventing adolescence pregnancies and providing antenatal care for pregnant adolescents. This dual approach enables the study to combine the various factors that are integral to the remedial strategies, regarding adolescent pregnancies in Sub-Saharan Africa.
The only flaw of this study is that it limits its methods towards the Sub-Saharan situation. The challenge of adolescent pregnancies is complicated and relative to cultural factors. It would mean that the applicability of the methods, adopted for this study, is only limited to the Sub-Saharan Africa situation. Implicitly, the study cannot be generalized to apply to other situations such as the United States of Africa and parts of Europe that continue to experience high incidents of adolescent pregnancies. However, this study would prove resourceful in addressing the topic of adolescent pregnancies in areas and regions that have a string cultural element to the problem.
Summary and Future Directions
Lessons, Learnt in the Study
In this study, I have learnt about the various factors that determine the high incidence of adolescent pregnancies in Sub-Saharan Africa. I have also learnt about the various causative factors together with the possible remedies that might be embraced by social workers to address the challenge. From the literature, I also learnt about the various health and psychological impacts of adolescent pregnancies on the vulnerable groups. The study showed that the high prevalence of adolescent pregnancies in Sub-Saharan Africa is influenced by environmental and cultural factors that are peculiar to the African region. The study also revealed that there is a dominant factor of socio-economic challenges, which determine the nature of adolescent pregnancies.
The different studies showed that poverty, low levels of education, and weak approaches to curriculum on reproductive health appeared as some of the determining factors of adolescent pregnancies. The literature explored also revealed that the incidents of adolescent pregnancies are linked to the degree of permissiveness of the society. It could be argued that adolescent pregnancies are a factor of various societal and individual factors that work together to determine the degrees of vulnerability of the teenagers. A comprehensive understanding of these factors would provide health practitioners with the best possible approaches of tacking the challenge. The study was based on a general approach that seeks to find a solution through the manipulation of the different structures that determine the nature and occurrence of adolescent pregnancies.
Specific Interventions for Health Workers
The intervention of health workers should be based on a comprehensive approach that combines cultural, medical, and psychological remedies for the challenge of adolescent pregnancies in Sub-Saharan Africa. Health workers must appreciate the fact that adolescent pregnancies are vulnerable and require close healthcare observation. Preventive measures such as increasing of awareness should be adopted for the purposes of increasing the knowledge and skills for the vulnerable groups. This could be done by conducting outreach missions to sensitize populations on the need to adopt safer practices.
Health workers should emphasize more on the sensitization of the vulnerable groups on the aspects of reproductive health with specific emphasis on adolescent pregnancies. Health workers should adopt approaches that seek to prevent teenage girls from the possibility of early pregnancies. Some of the approaches could include outreach programs that are directed towards sensitization and creation of awareness for the vulnerable, regarding the matter of teenage pregnancies. The creation of awareness must relate to the nature of associations between the various causative factors and the possible remedies to the challenge of adolescent pregnancies in Sub-Saharan Africa.
The second level of intervention should include psychosocial and prenatal therapies for victims of early pregnancies. Health workers should be cognizant of the cultural element in Sub-Saharan Africa so that they treat the girls in their totality as individuals, whose lives are largely determined by cultural factors. The identification of the negative influences and the promotion of positive attributes should dominate the strategies to be adopted by the health workers. Ultimately, the merit of this study lies in its recognition of the diverse and complex nature of human beings. The awareness of the complex interplay of factors that determine the occurrence and prevalence of adolescent pregnancies in Africa is fundamental to the general process of remedying the situation. The cultural, socio-economic, psychological, and medical approaches to the challenge of adolescent pregnancies are fundamental to resolving the challenge of adolescent pregnancies in Sub-Saharan Africa.